Roundup: Cracking The Cost-Savings Code In Mass.; Va. Releases Abortion Clinic Regs

A selection of health policy stories from Massachusetts, Virginia, Wisconsin, California, Minnesota, Oregon, Arizona, Illinois, Connecticut and North Carolina.

Politico: Massachusetts Bogged Down With Health Care Challenge
Gov. Deval Patrick wants Massachusetts to "crack the code" on health care costs, a punchy slogan he uses when he's promoting nationally the Bay State's cost-containment efforts. But transforming his ambition into policy has produced some messy sausage-making in his state Legislature. Key stakeholders aren't sure whether the springtime rush to craft a state approach to health care costs will create a national model -- much the way Massachusetts's 2006 coverage expansion signed by Gov. Mitt Romney helped create a framework for President Barack Obama's 2010 national health law. In fact, some are wondering whether the cost-savings effort will even work in Massachusetts (Cheney and Millman, 6/3).

Washington Post: Va. Health Dept. Releases Proposal Of Regulations For Abortion Clinics
The Virginia Health Department has released its proposed regulations governing abortion clinics -- rules that opponents say could put the clinics out of business. Emergency regulations have been in effect since Jan. 1. The state Board of Health will vote on the permanent regulations June 15. The proposed regulations are similar to the emergency regulations, which are considered some of the toughest in the country. They regulate the size of exam rooms and hallways and the number of parking spaces; and address requirements for inspections, medical procedures and record-keeping (6/2).

Milwaukee Journal Sentinel: Pair Sues State Over Health Insurance Aid 
Two Milwaukee residents have sued the state Department of Health Services for freezing enrollment in a program that provides basic health insurance for people with low incomes who are not eligible for other coverage. The program -- known as BadgerCare Plus Core -- covers about 26,000 people compared with 65,265 in January 2010. The BadgerCare Plus Core plan now has an estimated waiting list of 130,000 people (Boulton, 6/1).

Los Angeles Times: Traditional Dentistry Wary Of Dental Therapists
[Crystal Ann] Baker, who treats low-income patients in St. Paul, Minn., is among the nation's first dental therapists -- an innovative and controversial health position intended to fill socioeconomic and geographic gaps in dental care. With nearly 17 million children nationwide lacking dental care and health reform expected to increase demand, California and other states are exploring similar models to expand the dental workforce, setting the stage for a series of battles with dentist organizations that warn that patient safety is at stake (Gorman, 6/3).

WBUR's CommonHealth blog: Are We Lowering Health Costs Or Just Shifting Them To Consumers?
Why are premiums down and why are hospitals able to take a lower increase than in recent years? I haven’t seen much firm evidence that answers this question. But the latest report from the state's Division of Health Care Finance and Policy has some important analysis on the premiums question. Take a look at the far right column on this chart and note the premium increase in 2010 when "adjusted for benefits." If you put back all the costs that have shifted to members (higher co-pays, deductibles, co-insurance, etc.), premiums in 2010 would be rising at almost the same rate they have for the last decade or so. In health care-speak, this is called "benefit buydown." The market is producing lower premiums, but it is because patients are paying more health care costs on their own (Bebinger, 6/4).

Boston Globe: Cambridge Health Alliance CEO Aims To Improve Care Delivery
The new chief executive of Cambridge Health Alliance says he wants to improve the way medical care is delivered and paid for at the system’s three so-called safety net hospitals, but is also open to forging partnerships that may fall short of outright mergers. Patrick R. Wardell, 59,  who arrived here in mid-March from Michigan State University’s Hurley Medical Center in Flint, Mich., said he plans to spend the first six months working with his board on a plan to strengthen the finances of Cambridge Health Alliance, which serves a large population of low-income and immigrant patients (Weisman, 6/2).

Kaiser Health News: Debt Collectors In The ER
Former patients as well as top executives from Fairview and its former debt collector, Accretive Health, testified before a U.S. Senate hearing Wednesday in St. Paul, called by Sen. Al Franken (Stawicki, 6/1).

Arizona Republic: KidsCare II Open To Arizona's Uninsured Children
David Campos, 14, is among more than 100,000 Arizona children on a waiting list for KidsCare, the state health-insurance program for children whose parents earn too much to qualify for Medicaid but not enough to afford traditional insurance. A new, temporary version of the program opened May 1, and so far the state has enrolled about 2,500 kids. There's room for 21,700 children, and they will be covered through January 2014 (Reinhart, 6/2).

The Oregonian: For The Sickest Patients, Medicare Tests Home-Based Primary Care In Portland
In a given year, 10 percent of the people covered by Medicare account for nearly 60 percent of spending. A pilot project starting today in Portland aims to show that providing home-based primary care to Medicare patients with multiple chronic conditions can improve their health -- and save money. Housecall Providers, a Portland-based nonprofit, is one of 16 medical groups chosen from more than 130 applicants to participate in the Independence at Home demonstration. … A home-based primary care program started by the Department Veterans Affairs health system appears to have saved significant money. The VA says the program lowered the average annual cost of care for a patient with multiple chronic conditions from $38,168 to $29,036 (Rojas-Burke, 6/1).

Chicago Sun-Times: Nurse To Feds: State Grants Went To Politicians Campaigns
"Thousands of dollars" in state grants awarded to bolster health care in minority communities instead went to pay campaign workers for former state Sen. Rickey Hendon and Democratic candidates Hendon supported, a Chicago nurse has told investigators. The nurse, Tonja Cook, 44, detailed her allegations in four interviews with state and federal authorities between October 2010 and May 2011, records show (Fusco and McKinney, 6/4).

Modern Healthcare: Conn. AG Clears Yale-New Haven's Purchase Of St. Raphael
Yale-New Haven (Conn.) Hospital's bid to buy the Hospital of St. Raphael won clearance Connecticut's attorney general. The 959-bed Yale-New Haven Hospital reached a definitive agreement to purchase the 406-bed Hospital of St. Raphael in September 2011 (Evans, 6/2).

Modern Healthcare: Setting A Standard
For decades, most hospitals around the country have avoided paying taxes under a hazy set of standards without strong public oversight -- a state of affairs staunchly supported by hospital lobbyists and executives at the state and national level. But in Illinois, hospital officials were among the most ardent cheerleaders for new laws that will define, for the first time in the Land of Lincoln, precisely how not-for-profit hospitals qualify for their exemptions from taxes. Gov. Pat Quinn has vowed to the sign the bills, which are headed to his desk (Carlson, 6/2).

North Carolina Health News: Legislators Of Two Minds About Tobacco Cessation Programs 
Leaders in North Carolina’s House of Representatives can’t seem to decide whether they like smoking cessation programs, or not. On the same day the House passed a budget that would significantly cut funds [for] tobacco cessation, the House also adopted a resolution marking COPD Awareness day at the General Assembly (Hoban, 6/4). 

HealthyCal: Far From Cities, Children Lack Specialized Care
Local health care is virtually non-existent for children with special needs living in rural California.  Few doctors who are trained to treat the complex conditions that afflict these children practice in remote parts of the state. Traveling to major cities where physicians are more plentiful is often a day-long journey. Families often find that the multiple doctors their children see don’t have a system for communicating with each other, and parents must coordinate their child’s care themselves. But for many of these families, there is no alternative (Shanafelt and Gilligan, 6/4).

HealthyCal: Distance From Specialized Care Takes Toll On Parents, Too
Instead, most of [Crystal De Witt's] energy is spent getting Jace the ongoing medical attention he needs while keeping up with her fulltime work running an in-home daycare. His list of doctors is as long as his list of health problems and includes a gastroenterologist, audiologist, plastic surgeon, orthopedic surgeon and more, all specialists in pediatric care. Meeting these needs can become a fulltime job for any parent. But the task is even harder for people who live in the rural areas of California (Gilligan, 6/4).

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